Holistic Health Practices/Part 13
|By: Dr. John Ankerberg, Dr. John Weldon; ©2007|
|After medicine and dentistry, chiropractic is the largest health care system in the United States. Each year approximately 50,000 to 55,000 chiropractors treat 5 percent of the U.S. population. Chiropractic stresses the importance of the spine, believing that it is a vital organ of the body often neglected by contemporary medicine. But chiropractic theory and practice are frequently diverse and contradictory.|
What is Chiropractic?
After medicine and dentistry, chiropractic is the largest health care system in the United States. Each year approximately 50,000 to 55,000 chiropractors treat 5 percent of the U.S. population. Chiropractic was invented by D.D. Palmer (18441913), a “magnetic” healer with an interest in spiritism. Chiropractic stresses the importance of the spine, believing that it is a vital organ of the body often neglected by contemporary medicine. Today, chiropractic theory and practice are frequently diverse and contradictory. Methods range from those which are responsible and scientific to those which are irresponsible and unscientific. Conflicting theory and practice means that almost any evaluation of chiropractic can be challenged as “unrepresentative.” Nevertheless, the National Council Against Health Fraud’s position paper on chiropractic, based on extensive research, claims that “most chiropractors do not share the view of health and disease held by health scientists worldwide.” It supplies specific criteria which should be maintained by truly scientific practitioners of chiropractic.
It is important to realize that spinal manipulative therapy (SMT), used by chiropractors and many medical specialists such as physiatrists, is not necessarily the same as chiropractic. Manipulative therapy is safe, effective, and useful for treatment of back pain, headaches, and certain other musculoskeletal problems. Chiropractors are usually more skilled in this method than other practitioners because of their extensive training. But chiropractic as a whole may also involve more than manipulative therapy (incorporating additional treatments, some of which are New Age or scientifically questionable). Manipulative therapy itself may be over-utilized by chiropractors or applied to conditions for which there is no known justification.
Chiropractic treatment involves physical adjustments to correct “subluxations” or misalignments of the spine. Spinal misalignments allegedly impinge or cause pressure upon spinal nerves, interfering with the flow of nerve impulses to the rest of the body, producing disease or susceptibility to disease. By correcting subluxations, proper performance of the nervous system is allegedly restored, thereby improving or maintaining health. This is why medical and other dictionaries characteristically define chiropractic as a system of treating disease based on spinal manipulation. Chiropractors also maintain that one of their principal concerns is the prevention of disease through the correction of subluxations. Many chiropractors claim they can prevent or treat a significant number of illnesses and disorders that are unrelated to musculoskeletal problems. Chiropractic literature lists such conditions as high blood pressure, bronchial asthma, psychological problems, respiratory conditions, peptic ulcer, diabetes, heart trouble, etc. Practitioners believe that their clinical practice has produced results in improving or curing these conditions. They argue that such occasional clinical success means it is unfair to dismiss chiropractic’s potential role in treating organic illness without further research. Most medical texts note that the basic theory of chiropractic is not established and that chiropractic theory is not credible to the medical profession on the basis of current knowledge.
Writing in Scott Haldeman’s (ed.) Modern Developments in the Principles and Practice of Chiropractic (1980, pp. 36, 37), Walter I. Wardwell explains the dilemma:
- Chiropractors cannot have their cake and eat it too. To the extent that they reject the basic conceptions of medical science as fundamentally wrong, and propound chiropractic as a completely different philosophy and science capable of treating nearly the entire range of human ailments, they inevitably find great difficulty in convincing the mass of informed citizens that medicine’s evaluation of chiropractic is wrong. As an influential leader in the Christian Chiropractic Association told us, “‘No D.C. [Doctor of Chiropractic] wants to practice with medicine in any of its forms— pagan or scientific.”
Chiropractors claim that what is already known about the nervous system and its regulation of the body makes the concept of the chiropractic subluxation at least possible. Simply because we can’t prove the existence of subluxations or their effects is not the same as saying they cannot exist and have no influence on the body. In Chiropractors: A Consumers’ Guide (p. 46), John Lagone argues: “No one knows enough about the working of the nervous system to say with certainty that chiropractic cannot do what it says it can do.” Further, chiropractors maintain that medical doctors may “not understand the essential character of a subluxation” or may fail to note distinctions between structural defects which do not appear on X-ray and functional defects which will only become evident when a joint is examined through a range of motions.
Chiropractors also maintain that the results they obtain in their clinical practice indicate scientific research will eventually validate chiropractic theory.
Of course, if subluxations really help cause disease and chiropractors can remove them, thus helping cure disease, medical doctors and patients alike would be ecstatic. But even an article in the chiropractic journal, Journal of Manipulative and Physiological Therapeutics (January 1991, p. 48), commented, “Perhaps even more harmful to the profession is the absence of its own body of scientific research confirming and explaining the precise pathogenic nature of the subluxation and the health-promoting qualities of its elimination.”
Mark Bricklin, executive editor of Prevention magazine writes in The Practical Encyclopedia of Natural Healing (New York: Penguin, 1983-1990, p. 111): “Skeptics point out that there is no proof, no clinical evidence suggesting that if the spinal column is ‘like that of a newborn’s’ – clear of obstruction – there will be no disease. Or that chiropractic manipulations can be expected to speed relief of anything more than aches and pains of the musculoskeletal system.”
Critics wonder why of all the medical specialists in the world, only chiropractors are found to accept subluxations. As Hank Pizer, a noted medical writer observes in his Guide to the New Medicine: What Works, What Doesn’t (New York: William Morrow, 1982, p. 83), “The ‘subluxation’ that chiropractors refer to appears to be largely a theoretical construct accepted primarily by chiropractors.”
Science writer and chiropractic advocate John Lagone observes (p. 27) that “all chiropractors agree that the subluxation plays a role in disease and disorder. But their opinions differ as to what part of the body subluxation is found in, over how important it is to specific diseases and malfunctions, and over what constitutes proper treatment.”
Dr. William T. Jarvis is professor of prevention medicine at Loma Linda University and president of the National Council Against Health Fraud. He was awarded his Ph.D. for research on chiropractic. He writes as a critic of chiropractic and seeks to spur reform within the industry. In Ministry (May 1990, p. 26) he observes that chiropractors have never defined a subluxation in measurable terms, nor proven that it exists. He notes that in spite of the ability of neurophysiologists to measure nerve impulses, chiropractors have never shown that impinging a spinal nerve alters an impulse beyond the zone of impingement or that disrupting a nerve impulse can produce disease. He cites the important anatomical research of Yale University anatomist Edmund Crelin as having demonstrated that subluxations cannot function in the manner chiropractic claims. He also maintains that many studies have been conducted in which two or more chiropractors were unable to find the same subluxations either on the same X-ray or in the same patients, indicating that chiropractors can easily disagree over what specific conditions require treatment.
If subluxations exist and if there really is a chance that correcting them can cure disease, this would be wonderful. But this needs to be demonstrated by standard research. Relying upon the claims or experience of empirical medicine leaves one uncertain that the noted effects aren’t attributable to other causes.
Nevertheless, appropriate physical manipulation employed by chiropractors can be both safe and beneficial. General massage for headaches and rational conservative spinal manipulation therapy for some backaches and other neuromusculoskeletal disorders is medically justifiable. This is why most chiropractors apparently spend most of their time in treating neuromusculoskeletal symptoms. The British Medical Journal (June 2, 1990) reports that chiropractic “was more effective” for certain types of severe back pain than standard hospital outpatient management. The 1991 Rand Report concluded the following (p. V):
- The literature on the efficacy of spinal manipulation is of uneven quality…. Given that caveat, support is consistent for the use of spinal manipulation as a treatment for patients with acute low-back pain and an absence of other signs or symptoms of lower limb nerve-root involvement. Support is less clear for the other indications, with the evidence for some insufficient (acute and subacute low-back pain with sciatica, acute and subacute low-back pain with minor lower limb neurologic findings, most types of chronic back pain), while the evidence for others is conflicting (acute low-back pain with sciatica and minor lower limb neurological findings, subacute low-back pain without sciatica, and chronic lowback pain without sciatica).
Chiropractic, like dentistry, is a limited specialty that should not replace standard medical care. Responsible chiropractors are good physical therapists, not primary care physicians.
Although chiropractic itself is not New Age, unfortunately many chiropractors employ many of the holistic health treatments cited in this booklet. Some commentators believe chiropractic may play a key role in the advancement of holistic health in this country. Also, early chiropractic theory (incorporating a belief in a divine life-force called “Innate”) may open the door to occultic practices or beliefs among chiropractors who hold to this or similar views.
In addition, a number of New Age therapies have been developed by chiropractors – such as iridology, developed by Bernard Jensen; applied kinesiology, developed by George Goodhart; Touch for Health, developed by John Thie; and naprapathy, developed by Oakley G. Smith. Unfortunately, chiropractic almost singlehandedly began the fallacious practice of “muscle testing” in this country. We have also encountered a number of people who have become actual teachers of New Age therapies principally because their personal chiropractor used a particular New Age treatment on them, sparking their interest. Reflexology, iridology, homeopathy, and polarity therapy are examples.
The acceptance of undemonstrated theories or New Age methods that are found in modern chiropractic means that practitioners of chiropractic should be carefully evaluated before a patient begins treatment. The significant Christian influence within chiropractic should be at the forefront of reform within the industry.